Potential future agents in the management of mCRPC

A new article by Antonarakis and Armstrong in full text on the Medscape web site reviews available information on a wide range of currently investigational agents for the treatment of metastatic, castration-resistant prostate cancer (mCRPC), including

  • Novel androgen-directed approaches
    • Ortoronel (TAK-700)
    • MDV3100
    • TOK-001
    • ARN-509
  • Immune checkpoint blockade
    • Ipilimumab
  • Alternative targeted approaches
    • Custersin (OGX-011)
    • Survivin antagonists
    • Dasatinib and other Src kinase inhibitors
    • Angiogenesis inhibitors (including tasquinimod)
    • PI3K/Akt/mTOR pathway inhibitors (e.g., everolimus)
    • Insulin-like growth factor-1 receptor inhibitors (e.g., cixutumumab and figitumumab)
    • Epigenetic therapies
    • PARP inhibitors

It is possible that at least a couple of these agents could be approved for the treatment of mCRPC some time in 2012.

3 Responses

  1. This is a solid summary of the research with links to the publications for the agents described. This should be the starting point for those interested in the next steps available in 3-6 years.

  2. I have been taking the PI3K/Akt/mTOR pathway inhibitor rapamycin (a.k.a., sirolimus) for over a year and am unable to determine whether it is playing a role in slowing the progression of what appears as my recent hormone-refractory status. With that recurrence, my PSA was elevating very slowly, but progressively enough to acknowledge HRPC. I note that abiraterone acetate/Zytiga is not mentioned in the above list, and since my beginning this medication, 3 weeks later, my PSA had receded from 2.55 to 1.61 ng/ml. I am due for my next PSA check this coming Thursday after 2 months on Zytiga, so we shall see if it is still receding. It will be interesting if the several medications listed will be able to curb continued prostate cancer development.

  3. The reason that abiraterone acetate is not included in the article mentioned above is that it has already been approved for treatment of mCRPC.

    By contrast, the other drug that Chuck mentions (rapamycin or sirolimus) is approved by the US FDA exclusively for use in patients who have had a kidney transplant (to prevent organ rejection) and is marketed as Rapamune. It is not yet approved for the treatment of prostate cancer.

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